P038 Prevalence of syphilis in people living with HIV/AIDS in the Americas: a systematic review and meta-analysis of prevalence studies

Background Syphilis remains a public health threat, particularly in People Living with HIV/AIDS (PLWHA), due to its potential complications. The prevalence of syphilis in PLWHA in the Americas is not well characterised. Therefore, the aim of this systematic review and meta-analysis was to estimate the prevalence of syphilis in this population and to investigate sources of variation in these prevalences (PROSPERO CRD42020189246). Methods PubMed, Embase, LILACS and Web of Science were searched for studies reporting the prevalence point of Likely Exposure to Treponema Pallidum (LETP) by treponemal tests or Likely Current Syphilis Infection (LCSI) by the combination of treponemal and non-treponemal tests, in a broadly representative sample of PLWHA in the Americas. Published studies with less than 200 PLWHA, languages other than Spanish or English, and conference abstracts were excluded. A standardised data extraction form was used. A random-effects meta-analysis was performed to obtain the pooled prevalence of LETP and LCSI with their corresponding 95% prediction intervals (95%PI). Heterogeneity was investigated by a priori defined subpopulations diagnostic algorithm and geographical region. Heterogeneity was assessed via the Cochran’s Q test and I2 statistic, while Egger’s test was used to assess for publication bias. Results 25,848 records were identified, of which 49 unique studies with 67 prevalence points were included. The pooled prevalence in the Americas was 16.4% (95%PI 2.3–49.3) for LEPT, and 7.2% (95%PI 0.01–25.15) for LCSI, with high heterogeneity (I2 >75%, p-value 0.5). Conclusions The prevalences of LETP and LCSI are high in the Americas. Public health strategies should aim to create surveillance systems of syphilis in PLWHA and assure annual screening and timely treatment.